Provider Demographics
NPI:1033938667
Name:MOLINA GUZMAN, ARACELIS MARIA (APN)
Entity type:Individual
Prefix:
First Name:ARACELIS
Middle Name:MARIA
Last Name:MOLINA GUZMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 BEERS ST
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1405
Mailing Address - Country:US
Mailing Address - Phone:732-888-4100
Mailing Address - Fax:
Practice Address - Street 1:628 BEERS ST
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1405
Practice Address - Country:US
Practice Address - Phone:732-888-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ432085257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty